Summary of the Experiences and Results of Transesophageal Ultrasound-Guided Ventricular Septal Defect and Atrial Septal Defect Closure Operation
Summary of the Experiences and Results of Transesophageal Ultrasound-Guided Ventricular Septal Defect and Atrial Septal Defect Closure Operation
复制标题
超声引导下经食管室间隔缺损、房间隔缺损封堵术的经验和结果总结
DOI：
10.1532/hsf.4815
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发表时间：
2022
影响因子：
0.6
通讯作者：
Li Wan
中科院分区：
文献类型：
--
作者：
Fudong Wang;Wenjun Wang;Qicai Wu;Yuanping Cao;Huang Huang;Ende Tao;Qiao Fang;Liang Tang;Li Wan
背景：室间隔缺损（VSD）和房间隔缺损（ASD）是先天性心脏病。经胸封堵术（TC）和经皮封堵术（PC）治疗VSD和ASD的技术不断改进和成熟。本研究旨在回顾性分析TC和PC对VSD和ASD患者的治疗效果。方法：回顾性分析2010年8月至2020年8月在南昌大学第一附属医院心脏大血管外科接受经食管超声引导下TC或PC手术的928例患者（552例VSD和376例ASD），收集并评估患者的临床资料，包括年龄、性别、体重、缺损入口和出口直径以及TC和PC的手术结果。使用描述性统计分析平均值和标准差（SD），并使用卡方检验评估组间差异。结果：928例接受闭合手术的患者中，无人员伤亡，闭合成功907例（97.7%）。 552例接受TC治疗的VSD患者中，540例成功闭合，12例TC失败后需要体外循环。在376名ASD患者中，256名患者接受了TC治疗，其中251名患者成功，5名患者失败，其中3名脱落病例。此外，在接受PC治疗的120例患者中，116例成功，4例失败，其中2例脱落。封堵手术成功患者术后随访显示，未发生主动脉、三尖瓣反流、心包积水、Ⅲ°房室传导阻滞、封堵伞脱落、溶血、血栓等并发症。结论:食管超声闭合VSD、ASD手术具有创伤小、失血量少、住院时间短、手术简单、术后并发症少、治疗效果显着等优点。
Background: Ventricular septal defect (VSD) and atrial septal defect (ASD) are congenital heart diseases. The techniques of transthoracic closure (TC) and percutaneous closure (PC) for the treatment of VSD and ASD have continuously improved and matured. This study aimed to retrospectively analyze the therapeutic effects of TC and PC on VSD and ASD patients. Methods: We retrospectively reviewed 928 patients (552 VSD and 376 ASD) who had undergone TC or PC guided by transesophageal ultrasound at the Department of Cardiac Macrovascular Surgery of the First Affiliated Hospital of Nanchang University between August 2010 and August 2020. We collected and evaluated the clinical data of the patients, including age, gender, weight, inlet and outlet diameters of defect, and the operation results of TC and PC. Descriptive statistics were used to analyze means and standard deviations (SD), and the Chi-square test was used to evaluate the difference between groups. Results: Among the 928 patients who were treated with the closure operation, there were no casualties, with 907 patients (97.7%) showing successful closure. Among the 552 VSD patients who were treated with TC, 540 showed successful close, while 12 cases required extracorporeal circulation after the failure of TC. Among the 376 patients with ASD, 256 patients were treated with TC, of which 251 were successful, and five were failures, including three shedding cases. In addition, among the 120 patients who were treated with PC, 116 were successful, and four were failures, including two shedding cases. Postoperative follow up for patients with successful closure operations demonstrated that the complications of aortic and tricuspid regurgitation, hydro-pericardium, III° atrioventricular block, shedding of closure umbrella, hemolysis, and thrombosis had not occurred. Conclusion: Closure operation of VSD and ASD by esophageal ultrasound has the advantages of lower trauma and blood loss, shorter hospital stay, simple operation, fewer postoperative complications, and significant therapeutic efficacy.